<%= form_for(@patient) do |f| %>
  <% if @patient.errors.any? %>
    <div id="error_explanation">
      <h2><%= pluralize(@patient.errors.count, "error") %> prohibited this patient from being saved:</h2>

      <ul>
      <% @patient.errors.full_messages.each do |msg| %>
        <li><%= msg %></li>
      <% end %>
      </ul>
    </div>
  <% end %>

  <div class="field">
    <%= f.label :name %><br />
    <%= f.text_field :name %>
  </div>
  <div class="field">
    <%= f.label :gender %><br />
    <%= select_tag('patient[gender]', options_for_select([['Male', 'M'], ['Female', 'F']])) %>
 </div>
  <div class="field">
    <%= f.label :hiv_status %><br />
    <%= select_tag('patient[hiv_status]', options_for_select([['Unknown', 'Unknown'], ['Positive', 'positive'], ['Negative', 'negative']])) %>
  </div>
  <div class="field">
    <%= f.label :phone_number %><br />
    <%= f.text_field :phone_number %>
  </div>
  <div class="field">
    <%= f.check_box :deceased %>
    <%= f.label :deceased %><br />
  </div>
  <div class="field">
    <%= f.label :date_died %><br />
    <%= f.date_select :date_died %>
  </div>

  <div class="actions">
    <%= f.submit %>
  </div>
<% end %>
